Background:
Community-based health studies rely on the ability of researchers to successfully recruit and retain participants from a target population, rather than from clinical settings. Many prior studies of women's health have recruited in urban areas, but rural populations pose specific challenges.

Objectives:
This presentation describes strategies employed in the Central Pennsylvania Women's Health Study Phase II (CePAWHS-II) to recruit women in low-income rural communities to a randomized trial of a pre- and interconceptional health improvement intervention.

Methods:
Recruitment methods in low-income rural communities are described. Data are provided to show how enrolled women compared with women residing in the target communities on selected sociodemographic characteristics.

Results:
A triangular recruitment approach in each of 15 target communities consisted of: careful selection of an organizational community partner, active recruitment techniques (e.g., investigator presentations to community health and human service providers), and passive recruitment techniques (e.g., promotional materials posted in community settings). The groundwork for recruitment of low-income rural women was set by carefully selecting project partners as well as enlisting health and human services professionals, regional hospital and Federally Qualified Health Center (FQHC) representatives, academic researchers, and other community members from the CePAWHS Steering Committee. Overall, the project successfully recruited 696 women who met the project's eligibility criteria (e.g., age, reproductive health status, residence in target areas). Compared to the general population, the recruited women were more likely to be poor or near poor, rural, less well educated, not married or partnered, and non-white.

Conclusion and implications for practice:
Successful recruitment of typically hard to reach women, including low-income rural and minority women, is possible through implementation of a triangular recruitment approach in local communities.